Developmental Norms

Each child is an individual and therefore his/her respective speech and language development may differ slightly from his/her peers. However, there are developmental norms and generalities regarding what skills are expected to develop at specific ages. Following is a general outline of the different ages and developmental stages that are expected from children from birth to age five.

It is important to note that if your child is not performing 1-2 skills in a particular age range it may be an indicative of possible delayed hearing, speech, and/or language development. If your child is not performing 3 or more of the skills listed in a particular age range, it is imperative to take action and contact a Speech-Language Pathologist to find out if an evaluation or consultation is necessary. Additionally, included below is a compilation of common warning signs of a communication disorder. Please note that these lists are not all inclusive.

Furthermore, it is important to bear in mind that these developmental norms apply to monolingual children (children who speak one language). The norms for bilingual children (children who speak two languages) may differ due to the impact of the primary language, nationality, ethnicity, and culture.

What should my child be able to do?

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*Chart compiled from www.asha.org http://www.asha.org/public/speech/development/chart "How Does Your Child Hear and Talk?"

Common “red flags”:

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*Chart compiled from www.asha.org http://www.asha.org/public/speech/speech-referral “Behaviors that should trigger an SLP referral”

Speech referral guidelines for pediatrics from the American Speech Hearing Association (ASHA):

Most Common Etiologies

Cerebral palsy
Craniofacial disorders (e.g., cleft lip/palate)
Functional articulation and/or phonological disorders

Potential Consequences/Impact of Speech Impairment Can Include

Difficulty expressing need or routine information intelligibly
Difficulty communicating intelligibly in order to function at level of independence expected for age
Difficulty expressing feelings intelligibly; may be at risk for frustration or depression
Difficulty engaging successfully in social and/or classroom situations that require intelligible speech
Difficulty achieving adequate intelligible speech to reach educational potential
At risk for personal injury due to difficulty communicating intelligibly about a dangerous situation or calling for help

Behaviors that should trigger an SLP referral

By age 3 years cannot:

be understood by family and/or caregivers
correctly produce vowels and such sounds as p, b, m, w in words
repeat when not understood without becoming frustrated

By age 4 years cannot:

be understood by individuals with whom they do not associate regularly
be understood by family and/or caregivers
correctly produce t, d, k, g, f
be asked to repeat without becoming sensitive

By age 5 years cannot:

be understood in all situations by most listeners
correctly produce most speech sounds
be asked to repeat without exhibiting frustration

Disturbance in neuromuscular control causes difficulty learning to produce sounds appropriately

speech is usually slurred; difficulty controlling respiration for speech; abnormal loudness, rhythm, or vocal quality
exhibits difficulty learning sounds to form words; may sound nasal, strangled and/or breathy
exhibits frustration and/or avoidance of speech due to extreme difficulty forming sounds or difficulty being understood

Disturbance in programming, positioning, and sequencing of muscular movements

sound errors are prevalent but variable (i.e., "dog" could be produced "dog," "tog," "gog," "god" by same child)
varies from rarely being able to produce sounds to ongoing speech that is rarely understood, or speech that is usually understood with frequent sound errors
unaware of sound variations or exhibits varying degrees of frustration and/or anxiety regarding inability to "control speech"

Disturbance in performing voluntary movements with mouth and vocal mechanism

cannot produce movements for sound production or sounds are produced without voice (whispered speech)
varies from inability to produce any words to extreme difficulty being understood
exhibits frustration and/or avoidance of speech due to difficulties

Deafness/severe hearing loss causes severe prosodic disturbances in intonation, duration, and rhythm in addition to sound errors

produces no meaningful words or sounds understood only by family
speaks loudly in high pitched voice with frequent distortion, omission, and substitution of sounds

Autism, emotional disturbance, and/or mental retardation may cause very unusual prosodic variations

intonation and/or rhythm of connected speech may sound abnormal
volume may be consistently or intermittently too loud or too soft

Deviation in structure of speech mechanism

difficulty producing specific sounds and intelligible speech
exhibits frustration and/or avoidance of speech
speech has excessive nasality

Difficulty in hearing and/or inability to differentiate between sounds inhibit child's ability to detect and correct error sounds; usually unaware of errors
Intelligibility and sound production are compromised when nasal passages, nasopharynx, and larynx are bypassed due to tracheostomy/ventilator dependence

Exhibits sudden decrease in speech intelligibility

ranges from slurred, generally intelligible speech to total absence of speech, or totally unintelligible speech
awareness ranges from extremely aware to totally unaware of sound errors

Exhibits decline in ability to be understood by family, friends, and/or caregivers in the expression of basic needs, preferences, and feelings

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